The joy of Songkran is all too fleeting for Thailand’s Elderly

The celebration is all the more poignant when contrasted with the scenes of neglect of the elderly over the remaining 364 days of the year.

Like Christmas, Songkran means precious family time for most Thais. Bangkok is quieter than usual as migrant workers heading home jam roads leading out of the capital.

The reunions are an annual joy for Thailand’s elderly family members whose grownup children have emigrated to work in big cities. So it’s fitting that Traditional Thai New Year is also marked as National Senior Citizens Day, when the younger generation expresses gratitude to the elderly with garlands and by pouring scented water on their palms. In return, they receive blessings from the seniors.

The celebration is all the more poignant when contrasted with the scenes of neglect over the remaining 364 days of the year. A study by the Thailand Development Research Institute shows that fewer than half of Thais aged 60 or above can support themselves financially. Filling the gap is money sent home by their children and the monthly government stipend of less

Lthan Bt1,000. The stipend often goes on food or even medical costs accrued through difficulty accessing the universal health coverage scheme.

A World Bank study titled “Closing the Health Gaps for Thailand’s Elderly: Promoting Health Equity and Social Inclusion in Thailand” details obstacles to health services including a lack of transportation options and support for non-medical costs.

For those living in cities, that access is easier via public transport and taxis. But most villagers must rely on local clinics stocked with only basic medicines. If sick or disabled, their dire situation is often exacerbated by the exodus of grownup children to find jobs elsewhere. To take care of their parents, the kids seek help from relatives who are often from the same generation as their parents.

Isn’t there any scheme that could help them in a more sustainable way?

Indeed there is, but it requires cooperation from all in the community – municipalities, local hospitals and the villagers themselves. Such a scheme has already been launched in the Northeast province of Kalasin, its success documented by the World Bank.

To promote equal access to health and boost social support for the poor and vulnerable elderly, local administrative organisations in the province are implementing initiatives to help meet the rising demand for healthcare.

For bed-ridden elderly and those with mobility constraints, it can be more convenient to receive healthcare at home.

Staff from Kalasin Hospital and Village Health Volunteers have prioritised regular home visits to provide basic medical check-ups and screening, as well as organising physical exercise and informal health education sessions.

Village Health Volunteers receive 70 hours of formal training in elderly care taught by medical staff from Kalasin Hospital to ensure that services are appropriately and correctly delivered.

The Kalasin Provincial Health Office has also started the Suk Sala (village health centres) initiative to increase access to basic healthcare and reduce travel time and costs. Located in the heart of over 1,500 villages throughout the province, they are staffed by local health volunteers and offer basic services like blood-pressure checks, blood tests and prescription of basic medicines for the elderly.

Kalasin administrative organisations are promoting access to health services for the elderly through an emergency van service. Nij Simmho, 71, has diabetes and needs to travel for regular checkups. He used to pay Bt500 to get to the hospital but the van service is free and covers in all of Kalasin’s municipalities.

Municipalities like Tambon Najarn also allow the elderly poor to use the service even for normal hospital visits, not just emergencies.

Recently, the World Bank launched reports on “ageing” issues in which Thailand is extensively covered. The reports underscore that inadequate treatment will remain so without changes to public health services. World Bank experts have repeatedly said that this task is urgent given that Thailand’s ageing population is forecast to double in size in 20 years. In Western countries the same increase will take many more decades, allowing governments and people time to change attitudes and approaches.

The World Bank is currently highlighting Kalasin’s model as “something Thailand can promote and scale up to ensure that basic health care services for the elderly are available to all”.

Thailand needs a sustainable approach that ensures the elderly are properly cared for throughout the year, not just on National Senior Citizens Day.